[Echocardiographic septal motion in 50 patients with coronary artery disease. A correlative study with coronary angiographic findings (author's transl)].

The literature about pathological septal motion in coronary artery disease is contradictory. Purpose of this study was to reveal the sensitivity and specificity of the echocardiography for diagnosis of stenoses and occlusions (S/O) of the left anterior descending artery (LAD). 50 patients with CAD were studied using coronary angiography and echocardiography. In 32 of the cases a critical stenosis (over 70% narrowing) of the LAD was present. History of old infarction was found in 80% of the patients. Angina pectoris was absent at the time of the investigation. It was proven that the sensitivity of the echocardiography for the diagnosis of coronary stenoses and for proximal and peripheral LAD-S/O is not high (44%-61%). 50 percent of all LAD-S/O and 61% of the proximal LAD-S/O have a pathological septal movement. In presence of a pathological septal motion, however, it may be concluded that there is a critical stenosis in one or more of the three main coronary arteries (predictive value 91%). The diagnosis of the localization of the occlusion by echocardiography is not possible. 1/3 of peripheral LAD-S/O also lead to a dyscinetic septum which mostly is found in proximal LAD-S/O. The number of false positive (pathological) echocardiographic septal dyscinetic motion is low (12%). The sensitivity of echocardiographic method for diagnose of coronary alteration is increased when using the differentiation between stenosis and occlusion of LAD. By that it can be revealed that full occlusions of the LAD lead in 80% to septal dyscinetic motion, whereas stenoses are only rarely combined with pathological septum (36%). It is concluded that not only the localization but predominantly the degree of the vessel-narrowing influences the septal movement. Perhaps these findings may help to declare the contradictory results in literature.